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Thomas Willis
Thomas Willis (27 January 1621 - 11 December 1675) was a 17th century physician and neuroanatomist, considered by many to be the father of neuroscience. Willis’ work was considered revolutionary at the time, and extremely influential to the development of numerous medical and scientific disciplines related to the brain and nervous system.Lega, B. C. (2005). An Essay Concerning Human Understanding: How the Cerebri Anatome of Thomas Willis Influenced John Locke. Neurosurgery, 58(3), 567-576.Molnár, Z. (2004). Thomas Willis (1621-1675), the founder of clinical neuroscience. Neuroscience, 5, 329-335. Willis published six books throughout his life, with one posthumous publication. The most famous of these was Cerebri Anatome, a neuroanatomy text, in which Willis coined the term neurologie and which earned Willis his eponym: the circle of Willis. In addition to his own groundbreaking research, Willis was associated with some of the greatest scientific and medical minds of our time, and together with many of these colleagues he formed the Royal Society.Williams, A. N., Sunderland, R. (2001). Thomas Willis: the first paediatric neurologist? Archives of Disease in Childhood, 85, 506-509. Pre-Willis understanding of the brain Prior to Willis, knowledge of neuroanatomy was based primarily on the work of da Vinci, Berengario, and Vesalius.Dalley, A. F. (2002). Thomas Willis 1621-1675. Clinical Anatomy, 15, 2-3. They in turn were influenced by early anatomists such as Galen, who is credited with the notion that the brain is an organ for the purification and refinement of animal spirits. These spirits, which he proposed were phantom-like bodies with their own wills and intentions, were thought responsible for human disease, especially with regards to psychiatric disorders such as depression and insanity. Willis’ work with anatomy represents a blending of sorts with the hypotheses of early anatomists and philosophers, and his own clinical and experimental observations. Though he recognised that the work of his predecessors was flawed and inaccurate, he still held true to many archaic and non-scientific beliefs.Grand, W. (1999). The Anatomy of the Brain, by Thomas Willis. Neurosurgery, 45(5), 1234.Jay, V. (1998). The legacy of Thomas Willis. Child’s Nervous System, 14, 92-93. He maintained that animal spirits were the cause of human disease, and his primary motivation for studying anatomy was to understand the soul; both non-scientific, theoretical constructs impossible to observe.O’Connor, J. P. B. (2003). Thomas Willis and the background to Cerebri Anatome. Journal of the Royal Society of Medicine, 96(3), 139. Pre-Willis anatomists typically studied poorly preserved brains, but this was to change with the efforts of Sir Christopher Wren. Wren developed a preservation technique that he called chiriguia infusoria, which he and Willis adapted to use on the deceased brain. This technique prevented the brains from degrading into the formless mass that Willis’ predecessors were all too used to studying. Early life Thomas Willis was born on his parents’ farm in Great Bedwyn, Wiltshire, England on January 27, 1621. His parents, Rachael Howell and Thomas Willis, were staunch Royalists, and both Willis and his father would later serve in the Civil War, though Willis’ father would not survive.Rana, P. V. S. (2004). Dr. Thomas Willis and his ‘Circle’ in the Brain. Nepal Journal of Neuroscience, 2(1), 77-79.Üstün, Ç. (2004). Dr. Thomas Willis’ Famous Eponym: The Circle of Willis. Turkish Journal of Medical Sciences, 34, 271-274. The eldest of three sons, Willis attended the School of Edward Sylvester, and was accepted into the University of Oxford’s Christ Church College on March 3, 1637. Willis studied at Oxford for over nine years, graduating Bachelor of Arts (B.A.) in 1639, Master of Arts (M.A.) in 1642, and Bachelor of Medicine (B.M.) on December 8, 1646. While studying for his B.M, Willis served King Charles I in the ongoing Civil War, in the auxiliary regiment of the Earl of Dover. While it is unclear whether or not he actually participated in any battles, Willis’ loyalty and service to the King was rewarded by the early conferral of his medical degree, despite the fact he was seven years away from graduating from the fourteen year program. Medical career Following his early graduation, Willis began practicing in a town near Oxford. As only experienced and established physicians were located in Oxford, he required clinical experience before he could return there to practice. During this time he took a pro-active role in advertising his practice; visiting local markets and offering his service to patrons. At the time, it was common practice for physicians to contact one another to discuss the symptoms and diagnoses of their patients. Willis made a habit of consulting with numerous physicians, neuoranatomists, and scientists in general. He maintained a close association with many of these scientific and medical colleagues, who included Sir Christopher Wren, a renowned artist and architect; Richard Lower, a physician, anatomist and physiologist; the physicists Robert Hooke, Robert Boyle and Isaac Newton; and the noted physician-turned-philosopher, John Locke.Caplan, L. (2000). Posterior Circulation Ischemia: Then, Now, and Tomorrow: The Thomas Willis Lecture – 2000. Stroke, 31, 2011-2023. Willis would later work closely with Christopher Wren and Richard Lower while producing Cerebri Anatome. The two contributed drawings and assisted with dissections. Willis fully acknowledged their role in Cerebri Anatome’s production. Willis’ breakthrough as a physician came about with the revival of Anne Green on December 14, 1650. Green, a 22 year old servant, was a prisoner of the state who was convicted of the infanticide of her newborn child, and was sentenced to be hanged at the Cattle Yard in Oxford. At the time, obtaining corpses for anatomical dissection was difficult, so the bodies of executed individuals were typically donated to universities. Green’s body was amongst these forcibly ‘donated’ to science. She was delivered to the home of William Petty (1623-1687), a colleague of Willis’ and a lecturer in anatomy at Oxford. When the coffin was opened, an audible gagging was heard and Green started to breath. Together Petty and Willis resuscitated the ‘corpse’, using unorthodox but ultimately successful techniques. Her remarkable recovery caused a lot of envy towards Willis from fellow physicians. Academic career Willis married Mary Fell on April 7, 1657. Mary was a close relative of John Fell, Dean of Christ Church (some sources state the two were siblings, others claim Mary was John’s daughter). Fell gave birth to eight children throughout their marriage; four sons and four daughters. Reports are conflicting, but only one or two of his children survived, one being his eldest son. It was around this time that both of Willis’ brothers also died prematurely. Shortly after, in 1666, Willis’ wife Mary Fell also passed away. Despite his numerous losses, Willis carried on with his research and clinical practice. Following the publicity regarding Green, Willis was elected Sedleian Professor of Natural Philosophy at Oxford in 1660. His appointment was endorsed by Gilbert Sheldon (1598-1677) who had been a strong supporter of Willis throughout his career. After his appointment, Willis devoted himself to neuroanatomy, which he equated as “opening heads” (Jay, 1998, p. 92). In particular, his zest for research was greatly influenced by his realisation that the brain’s anatomy had been inaccurately described by his predecessors. At the behest of the Archbishop of Canterbury, Willis moved to London in 1667, where he would remain for the last nine years of his life. There he established a prosperous practice that added to his already considerable wealth. He treated the poor free of charge, while billing his wealthy patients large amounts of money for his service. Neuroanatomy, neuropathology and the circle of Willis Willis is credited with coining the term neurology (originally neurologie), which first appears in Cerebri Anatome.Hughes, J. T. (2000). Thomas Willis (1621-1675). Journal of Neurology, 247, 151-152. He is regarded by modern physicians and anatomists as the founder of clinical neuroscience, neurology, comparative anatomy, and neuroanatomy; as well as being incredibly influential to the development of medicine and science as a whole.Grand, W. (1999). The Anatomy of the Brain, by Thomas Willis. Neurosurgery, 45(5), 1234. In addition, he made “significant original contributions” to cardiology, endocrinology, and gastroenterology (Williams & Sunderland, 2001, p. 506). Though not the first to describe the arterial circle at the base of the brain that today bear’s his name, Willis did describe it in the most detail. Before him, Fallopius (1523-1562), Casserio (1552-1616), Vesling (1598-1649), and Webfer (1620-1695) had all mentioned this arterial circle in their respective publications. Willis acknowledged all of these studies. Their accounts, however, lacked Willis’ investigation and insight. Willis is credited with being the first to understand the probable function and physiological importance of the arterial circle, as well as providing a complete description and illustration of its vascular pattern.Jay, V. (1999). Dr Thomas Willis. Archives of Pathology & Laboratory Medicine, 123(5), 377. Aside from the eponymous ‘circle of Willis’, Thomas Willis was responsible for the naming of numerous regions of the brain and nervous system, and of even more neurological and general pathologies, which he usually observed and studied in his own patients. His success as a neuroanatomist is often attributed to his use of longitudinal studies in his patients, which typically culminated in dissecting and studying them after their death. In so, he would relate altered behaviour he observed during their life to neurological deficits and deformities discovered during autopsy. Neuroanatomic terms coined by Willis *Anterior commissure *Cerebellar peduncles *Claustrum *Corpus striatum *Inferior olives (corpora teretia) *Internal capsule *Medullary pyramids *Nervous ophthalmicus *The word ‘neurology’ (neurologie) *Optic thalamus *Spinal accessory nerve *Stria terminalis (taenia cornua) *Striatum *Vagus nerve Pathologies recognised by Willis *Achalasia of the cardia (achalasia of the oesophagus) *Akathisia (restless legs syndrome, Ekbom’s syndrome) *Symptoms of the myasthenia gravis *Paracusis Willisisii (occurs in deaf patients whose hearing improves in the presence of noise, indicating osteosclerosis) *Diabetes mellitus *Abnormalities of the brains of patients with congenital mental retardation *Unilateral degeneration of the cerebral peduncle in a case of long-standing unilateral paralysis *Symptoms of malaria *Distinctions between typhoid and puerperal fevers ''Cerebri Anatome'' While Sedleian Professor of Natural Philosophy at Oxford, Willis began work on Cerebri Anatome cui Accessit Nervorum Descriptio et Usus, a definitive text on anatomy that remained the “most significant contribution to neuroanatomy for almost 200 years” (Molnár, 2004, p. 333; O’Connor, 2003). It was published in Latin in 1664, and though initially it had little influence on clinical medicine, it did serve to enhance Willis’ reputation.O’Connor, J. P. B. (2003). Thomas Willis and the background to Cerebri Anatome. Journal of the Royal Society of Medicine, 96(3), 139. A comparative text which contrasted human neuroanatomy to that of animals, Cerebri Anatome was considered revolutionary at the time, in no small part due to Christopher Wren’s preservation techniques, which allowed the study of well-preserved brains; and his illustrations, which far surpassed those of previous texts. Cerebri Anatome contains 29 chapters on the anatomy and function of the brain and nervous system. It represented a breakthrough in medical science, physiology, and especially neuroanatomy. Willis’ primary motivation for studying anatomy, and subsequently publishing Cerebri Anatome was to investigate the nature of the soul. He believed anatomy could differentiate the structural differences between humans and animals, proving that man had an immortal soul which allowed higher cognitive function than that allowed by the soul held in common with animals. Finally, Willis’ decision to publish Cerebri Anatome in Latin, despite the developing trend to publish in English shows his support for the Church and the King. Latin was the language of scholars, the Church, and the monarchy, so by using it he established himself as an academic authority while his text had an ever-present reminder of his allegiances. Willis' legacy Willis died of pleurisy in London on December 11, 1675, likely caused by pneumonia. He is buried in Westminster Abbey. Throughout his life he published six books, and garnered a reputation as one of the most prominent physicians in England. Indeed, he was the treating physician, and often consulted regarding treatment, of members of the royal family. Willis was also influential to philosophy. The noted philosopher John Locke (who was originally a physician) published his acclaimed piece, An Essay Concerning Human Understanding, “immediately after the groundbreaking neuroanatomical investigations of Thomas Willis (Lega, 2005, p. 567). Locke was a student at Oxford in the 1650’s and early 1660’s, when Willis was a newly appointed professor. Locke “avidly attended Willis’ lectures”, and indeed his notes from those lectures form a major portion of resource materials for Willis’ ideas (Lega, 2005. p. 569). Many of Willis’ ideas, or adaptations of such, appear in An Essay, including Locke’s view on perception, which was heavily influenced by Willis. Willis’ legacy is best illustrated when looking at his lasting contributions to neuroscience and its associated fields. He discovered morphological differences between normal brains and those of individuals with congenital mental retardation. His classification of the cranial nerves prevailed for more than 100 years before it was superseded. He was also the first to propose the convolutions of the cerebral cortex in humans were responsible for higher cognitive functions. In addition, he correctly surmised that the brainstem and cerebellum were more instinctive and reflexively based than the rest of the brain. Willis' publications *''Diatribae Duae Medico-Philosophicae'' (1659) **A piece on the biochemistry of the body, based on Willis’ own scientific investigations. Contains a large amount of information on fevers. *''Cerebri Anatome cue Accessit Nervorum Descriptio et Usus'' (1664) **Willis’ most famous publication, which details the anatomy and functions of the brain, spinal cord and nervous systems. In addition, comparisons were made between human neuroanatomy and that of animals. *''Pathologiae Cerebri et Nervosi Generis Specimen'' (1667) **Contains some of the first descriptions of neurological disorders, including epilepsy and asthma. *''Affectionum Quae Dicuntur Hystericae et Hypochondriacae'' (1670) **Divided into three parts: hysteria and hypochondria, blood, and muscular action. *''De Anima Brutorum Quae Hominis Vitalis ac Sensitiva Est'' (1672) **A continuation of Cerebri Anatome, Willis again investigates the soul-brain connection, via the comparative analysis of different nervous systems. *''Phamaceuticae Rationalis'' (1674-1675) **The first volume (1674) describes pharmacological treatments along with Willis’ clinical observations of their effects. The second volume (1675) was published shortly after Willis’ death and further explores pathologies and treatment approaches. *A Plain and Easie Method of Preserving Those That are Well From the Plague (1691) **Willis’ only book to be published in English, this is a posthumous publication of work Willis undertook circa 1666. References